How Can Nerve Stimulation Help Overactive Bladder
There are several treatments that involve stimulating your nerves to help improve overactive bladder. Your nerves help communicate the message that your bladder needs to be emptied to your brain. By treating the nerves, your healthcare provider can improve your bladder control. Nerve stimulation is a reversible treatment that is considered when conservative treatments have not worked or have not been tolerated. Conservative treatments include behavioral therapies and medications.
There are several types of nerve stimulation treatments. These can include:
Overactive Bladder And Urge Urinary Incontinence In The Workplace
Any discussion of the effects of OAB and urge urinary incontinence in younger women has to consider the effects of these disorders in the workplace. Incontinence in working-age women has genuine economic consequences. Fultz and colleagues27 conducted a mail survey of women born in 1947 or earlier to assess their time use and activity patterns, including time spent at work. Incontinent women reported significantly fewer hours working for pay than did continent women. The median number of hours
Duration Of Overactive Bladder
In some people, overactive bladder is the result of health conditions that may improve over time or with treatment. In other people, OAB is caused by lasting or permanent health problems.
How long your OAB lasts will depend on its specific causes, as well as how effective your treatments are for both underlying conditions and OAB.
Even if your OAB doesnt go away completely with treatment, you may be able to reduce its severity or impact on your life. Doing so may include both lifestyle changes to reduce your symptoms and adaptive measures to prepare for symptoms.
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Signs And Symptoms Of Overactive Bladder
Symptoms of overactive bladder vary from person to person, and may include:
- Sudden, urgent need to urinate
- Difficulty holding in urine
- Frequent urination
- Unintentional loss of urine with urgent need to urinate
- Waking up more than once or twice at night to urinate
The defining symptom of overactive bladder is sudden, strong urges to urinate. You may fear that youll leak urine on the way to the bathroom.
Even if you dont actually leak urine, OAB can disrupt your life and may cause significant distress.
What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
Often, there may be no specific explanation for why this is occurring.
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What Are The Treatment Options
A number of treatment options are available to younger women with OAB with or without urge urinary incontinence. Behavioral treatment aims to improve bladder control in the incontinent patient by 2 means: changing the patients voiding habits and teaching skills to prevent urine loss.34 There are a number of approaches to behavioral therapy for treating incontinence among them are bladder drill and bladder training. Multicomponent behavioral training, which might include pelvic floor muscle
Try Pelvic Floor Therapy
Pelvic floor therapy is a type of specialized physical therapy that strengthens the muscles that support your bladder and bowels. This can be very effective in treating urinary incontinence caused by an overactive bladder.
During pelvic floor therapy, a physical therapist may lead you through exercises that target your pelvic floor, use mild electrical stimulation to help you have more awareness of your pelvic floor muscles, and use other specialized techniques. If youre interested in pelvic floor therapy, talk with a doctor about getting a referral.
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Keeping A Bathroom Journal
You may be asked to keep a bathroom journal before or after your appointment. In your journal, youll log all your bathroom trips and bladder leakage or issues. It can also be helpful to record what you eat and drink in your bladder journal. This record will help your doctor get a more accurate idea of your symptoms and how often they occur. Keeping a journal can also determine what triggers your need to pee or any accidents.
Related Conditions Of Overactive Bladder
Overactive bladder is distinct from, but related to, a number of other bladder and urinary conditions.
All of these conditions may be called bladder control problems. Healthcare providers may refer to them as lower urinary tract symptoms .
Other conditions that shouldnt be confused with overactive bladder include:
Stress Incontinence This refers to urine leakage due to movement, which puts pressure on your bladder. It can be caused by coughing, sneezing, laughing, or physical activity.
Reflex Incontinence This refers to urine leakage without any warning or urge. Its often caused by damaged bladder nerves.
Overflow Incontinence This condition can affect people who have difficulty fully emptying their bladder. As a result, the bladder can more easily overflow and leak as a result.
Functional Incontinence This happens when an outside barrier, such as a physical or mental disability, prevents someone from reaching a toilet in time to urinate, resulting in urine leakage.
Temporary Incontinence Urine leakage can happen due to a temporary illness that passes, such as a bad cough.
Bed-Wetting Also known as nocturnal enuresis, bed-wetting can affect adults as well as children. It may be worsened by certain medicines or by consuming caffeine or alcohol late in the evening.
Certain health problems may cause both bed-wetting and frequent nighttime urination. These conditions include kidney stones, a urinary tract infection , enlarged prostate, and obstructive sleep apnea.
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Coping With Incontinence: Lifestyle Changes
But for most women, a little absorbent pad is their first weapon, a lifestyle change their second.
For many women the change may be as simple as drinking less water.
“You can’t drink two big bottles of water at one time, because it comes through your system as one big of fluid,” says Brubaker. “If you have a little at a time, it’s much easier for the bladder.”
Perhaps you just need to urinate more frequently – especially before getting onto the tennis court, for example.
You may also simply learn to brace yourself when you laugh or cough, tightening your pelvic muscles to prevent leaks.
“Women are smart…” says Brubaker. “They try a bunch of things on their own before they get the gumption to talk to someone about it.”
Overactive Bladder In Women
Women are more likely to report symptoms of OAB to their doctor. In fact, at least 40 percent of American women experience symptoms of overactive bladder. Many more may not report the experiences to their doctor at all.
Overactive bladder consists of a series of symptoms that cause you to need to urinate more frequently. These symptoms include
- feeling a sudden need to urinate
- not being able to control urination
- urinating at least two times every night
- urinating at least eight times every day
Its not clear what causes overactive bladder, but OAB becomes more common in women after menopause. That may be the result of estrogen deficiency. However, overactive bladder can occur at any age.
Overactive bladder is a common childhood condition, but not every accident or soiled bed is the result of OAB. Children frequently grow out of overactive bladder symptoms, but treatment can help prevent frequent urination or complications.
Symptoms of OAB in children include:
- an urgent or frequent need to urinate
- accidents or leaking urine
- urinating more than eight times in a day
- not feeling as if theyve emptied their bladder despite urinating
Symptoms of OAB become less common as children get older. With age, kids learn to properly control their bladder and recognize signals that they need to urinate. If symptoms of overactive bladder dont seem to be resolving or are getting worse, talk with your childs doctor.
Causes of OAB in children include:
- urinary tract infection
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Pathophysiology Of Overactive Bladder And Urge Urinary Incontinence
The cardinal feature of OAB is a feeling of urinary urgency, which may occur with or without urge incontinence. Urgency is usually accompanied by urinary frequency and nocturia.1 These symptoms are often the result of involuntary contractions of the detrusor muscle during bladder filling.2 In normal function there is an absence of involuntary phasic contractions as the detrusor allows the bladder to fill with little or no change in pressure.2 In cases where a neurologic condition is associated
Whats A Normal Number Of Bathroom Visits
There is no normal number of bathroom visits per day, which makes it difficult to know how many trips to the bathroom might indicate OAB. A very general guideline is that making fewer than 10 visits to the bathroom per day suggests normal bladder function. Its important to acknowledge if youre urinating more often than usual or if you feel an uncontrollable need to urinate.
Can Overactive Bladder Be Controlled
Overactive bladder therapy can be challenging to manage. However, many people are very satisfied with the treatment they receive and they often see a dramatic improvement in their quality of life. Your doctor will guide you to the best steps to begin with and give you options for any additional treatments you may need over time.
Complementary Alternative And Integrative Therapies And Practices
There may be steps you can take on your own to improve your bladder control, either with or without medical therapies.
Keeping a bladder diary tracking your urination as well as food and beverage intake, and other activities can help you figure out what foods or behaviors might contribute to OAB.
Changing your urination behaviors may help train your brain to send signals to urinate in a more regular way. Techniques that may be helpful include:
- Delayed voiding
- Timed urination
Its a good idea to talk with your doctor about these techniques before trying any of them.
You may also benefit from exercises that use your pelvic floor muscles, including the following:
- Kegels This exercise involves squeezing your pelvic muscles tight for a few seconds, then relaxing and repeating this for a set number of repetitions.
- Quick Flicks When you have the urge to urinate, you may be able to help control it by quickly squeezing and relaxing your pelvic muscles over and over.
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How Do I Do Kegel Exercises
To do Kegels:
If you are uncomfortable or uncertain about doing Kegel exercises on your own, a doctor or nurse can also teach you how to do Kegels. A pelvic floor physical therapist or other specialist may also be available in your area to help teach you how to strengthen these muscles.
How Is Incontinence Evaluated
The first step toward relief is to see a doctor who has experience treating incontinence to learn what type you have. A urologist specializes in the urinary tract, and some urologists further specialize in the female urinary tract. Gynecologists and obstetricians specialize in the female reproductive tract and childbirth. A urogynecologist focuses on urinary and associated pelvic problems in women. Family practitioners and internists see patients for all kinds of health conditions. Any of these doctors may be able to help you. In addition, some nurses and other health care providers often provide rehabilitation services and teach behavioral therapies such as fluid management and pelvic floor strengthening.
To diagnose the problem, your doctor will first ask about symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence you have. Thus, many specialists begin with having you fill out a bladder diary over several days. These diaries can reveal obvious factors that can help define the problem — including straining and discomfort, fluid intake, use of drugs, recent surgery, and illness. Often you can begin treatment at the first medical visit.
If your diary and medical history do not define the problem, they will at least suggest which tests you need.
Behavioral Remedies: Bladder Retraining and Kegel Exercises
How do you do Kegel exercises?
Medicines for Overactive Bladder
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How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better
It may take 4 to 6 weeks before you notice any improvement in your symptoms.10
Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms dont get better, Kegel exercises can help prevent your incontinence from getting worse.
You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.
Treatment Options For Overactive Bladder
- Behavioral therapies to help you regain control of their bladder
- Watch the type, quantity and timing of food and drink that you take in
- Avoiding foods and beverages that are likely to cause OAB symptoms
- Regular toileting to prevent the bladder from getting too full
- Weight Loss: Being overweight puts extra pressure on your bladder. Weight loss may help relieve some of the symptoms of OAB.
- Urinate on a Schedule: Sometimes, the message that the bladder is full comes without warning and often too late. In these cases, women find that they lose urine on the way to the bathroom. There isn’t enough time between the message and their ability to get to the bathroom before they start to leak. Voiding on a schedule, also referred to as “Timed Voids” may help prevent urgency and urgency incontinence.
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Behavioral And Lifestyle Changes
Performing pelvic floor exercises, known as Kegels, strengthens the pelvic floor muscles and the sphincter, a urinary muscle. Scheduling toilet trips for every couple of hours, as well as managing and reducing fluid intake, will help women normalize their urine schedule. Bladder training involves delaying urination after the initial sensation hits and building up the intervals between urinating over time.
Prevention Of Overactive Bladder
Following a healthy diet and getting enough physical activity can help improve bladder symptoms by strengthening muscles in your torso, ensuring bowel regularity, and helping you maintain a healthy body weight.
Certain foods and ingredients can irritate your bladder, and you may want to keep a diary to figure out whether any are contributing to your symptoms.
Foods and beverages that may contribute to OAB include:
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How Diet Affects Oab
When our bodies create urine, its made up of the liquid waste that the kidneys filter from our blood. Traces of the foods and drinks we consume can therefore end up in our urine, which is then stored in the bladder. Some foods that you eat may actually irritate your bladder, causing bladder spasms, that gotta go now feeling, and even bladder leaks.
People who have a sensitivity to gluten may also experience overactive bladder symptoms, as the bladder can be irritated by gluten. Eliminating foods with wheat, rye and barley may help to alleviate symptoms of OAB.
What You Need To Know
Assess potential underlying causes of overactive bladder syndrome, which is characterised by urinary urgency usually with accompanying frequency and nocturia
Avoid anticholinergic medication in elderly, frail patients or those with a high anticholinergic burden
Solifenacin and mirabegron can be safely combined to improve symptoms if a single agent is ineffective
A 65 year old woman presents to her general practitioner complaining of knee pain. She reports that this makes it difficult for her to get to the toilet in time. On further questioning, she describes urinary frequency and urgency with occasional incontinence episodes, and explains that she knows where all the toilets are on her regular commutes.
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